APPLICATION FORM

Note: All the information shared will be kept very confidential and shall not be used for any other purpose
other than for the review for the certification purpose.
Format Review Frequency = 1 Year
Date of Application

Organization Name

Postal Code
Registered Address State
Country
Contact Details Primary Details Secondary Details

Name of the Person

Designation

Phone No.

Email Id

Website

No. of Sites
Postal Code
Site 1 Address State
(Head Office) Country
Postal Code
Site 2 Address State
Country
Add another Location by Insert Rows Below
Private Public Proprietorship Partnership
Legal Status of
Company Govt. PSU LLP Other _________
Undertaken
Statutory and Write some legal document of this company
Regulatory
Requirement
Applicable
Person responsible Name:
for Email:
Regulatory
Compliance
For India Only
GST Registration
No.

Ref: SIS – F - 002 Issue No. 05 Rev. No. 01 Revision Date: 10.07.2024

Unit No. 514, 5th Floor,Vipul Business Park, Sohna Road, Sector – 48, Gurgaon-122018, Haryana, India.
Where did you hear
about us

How did you reach

us?
IAS UAF
Accreditation Board Others___________
ISO 9001:2015 ISO 14001:2015 ISO 45001:2018 ISO 22000:2018

Required ISO ISO ISO 19650 ISO 27701:2019 ISO

Standards and 27001:2013 13485:2016
Other Standards
ISO ISO ISO 22301:2019 ISO
50001:2011 26000:2010 45005:2020
ISO ISO ISO 21000:2018 ISO
37001:2016 31001:2018 41001:2018
ISO ISO ISO 22609:2014 ISO
31000:2018 13482:2014 14310:2008
HSE HACCP CE Marking HALAL

KOSHER ROHS GMP/GHP/GLP

If any other, Please Mention:

Scope of
Certifications

Brief about your

Services and
Products
Product For Product Certification Only
Specifications for
Product
Certification
(Please attach
technical
Specifications)
Clause Justification
Exclusion (if any)

Ref: SIS – F - 002 Issue No. 05 Rev. No. 01 Revision Date: 10.07.2024

Unit No. 514, 5th Floor,Vipul Business Park, Sohna Road, Sector – 48, Gurgaon-122018, Haryana, India.
Establish, Status of the documentation
development and
Implementation
Status of Standard
(Manuals, Procedures
and records
availability as per the
requirements of the
standard)
List of outsourced process
Details of
Outsourced Process
Employees Details
Location No. of Working Total Full Part Unskilled Design & Off *Effective
Shifts hours Employee Time Time workers Development Site No. of
Team Employees
Site 1

Site2

Total
Total Number of For Schools & Colleges Only
Students
(For Education
Industry)
Type & Total
Occupancy
(Restaurants, Hotels,
Hospitals)
*Note: For EnMS certification the number of personnel shall be who materially impact to EnMS and includes
Personnel that contribute to Energy Performance Number of the EnMS Effective Personnel
Top Management

Management Representative(s)

Energy Management Team

Person responsible for major changes affecting energy

performance
Person(s) responsible for developing, implementing or
maintaining energy performance improvements including
objectives, targets and action plans
Person(s) responsible for significant energy uses

Total Number of the EnMS Effective Personnel

For Transfer Case

Note: Forward copy of latest audit
report and current certificate
Ref: SIS – F - 002 Issue No. 05 Rev. No. 01 Revision Date: 10.07.2024

Unit No. 514, 5th Floor,Vipul Business Park, Sohna Road, Sector – 48, Gurgaon-122018, Haryana, India.
Certificat Initial Surveillance Recertification Certificate No:
ion status No. __________ CB:
AB:
If existing SIS Certification Accreditation Board
provided Certificate No
another standard other than this Standard(s)
Surveillance frequency 06 months 09 months 12 months

Combined Audit Yes No

(In the case of several If the answer is yes, please specified which combination:
certification programs, would
you like the audits to be
Combined or carried out
separately?)
Yes No
Joint audit If yes, please mention the other auditing organization’s name:

Yes No
Consultants Involved If Answer is yes, Mention Name of the Consultants:

Key Process Involved

Or Interaction of processes
Level of Integration 1. An integrated documentation set, including work instructions to a good level of
development, as appropriate
(Applicable for Only for 2. Management Reviews that consider the overall business strategy and plan
Integrated Management 3. An integrated approach to internal audits
System) 4. An integrated approach to policy and objectives
5. An integrated approach to systems processes
6. An integrated approach to improvement mechanisms, (corrective and preventive action;
measurement and continual Improvement)
7. Integrated management support and responsibilities.
8. Auditee understanding of all the IMS Standards
Additional Information Required (Standard-wise)
How many sites the Company is Managing at the same time? …………………………………….

Do you have Register of Significant Environment aspect? Yes No

EMS Do you have an Environmental Management Manual? Yes No
Do you have an Internal Environmental Audit Programme? Yes No
Has the Internal Environmental Audit Programme been implemented? Yes No
HACCP Implementation or Study Conducted: Yes No
FSMS No. of HACCP Studies……………… No of Sites………….
No. of Process Lines: ……………….
Processing is: Seasonal Continuous

Ref: SIS – F - 002 Issue No. 05 Rev. No. 01 Revision Date: 10.07.2024

Unit No. 514, 5th Floor,Vipul Business Park, Sohna Road, Sector – 48, Gurgaon-122018, Haryana, India.
 Hazards Identified? Yes No
OHSMS Any critical occupational health & safety risks identified? (If yes, please mention the details)
………………………………………………………………………………………………………………
Nearby Hospital Name & its Distance from the Site
……………………………………………………………………………………………………………...
Do you have Empaneled Doctor or Nurse
……………………………………………………………………………………………………………….
Annual Energy Consumption (TJ): …………………………………………………………………………
EnMS No of Energy Sources: …………………………………………………………………………………….
Number of significant energies uses (SEUs): ………………………………………………………………
Classification + rules (for products acc. to MDD): ………………………………………………………...
Medical Class: ……………………………………………………………………………………………...
Risk Level: High High-Medium Low-Medium Low
MD-QMS Main Technical Area: ………………………………………………………………………………………
Technical Area: …………………………………………………………………………………………….
Product Categories covered by the Technical Area: ……………………………………………………….
Is the sterilization process validated with the specified products? …………………………………………
If yes, is the sterilization performed in house? ……………………………………………………………..
BCMS 1. Do you have business continuity analysis and risk assessment register? Yes No
2. Do you have business continuity plans? Yes No
3. Do you have business performance evaluation process? Yes No
EOMS [Link] of educational services offered:
Pre-primary/Primary/Secondary/University/College/Vocational, including professional higher education and
apprenticeships/continuing education (adult education) / Tutoring, coaching and mentoring.

2. Indicate whether the organization has branches at different locations or multiple-sites of operations.
Yes No
If yes, give name(s) & address(es) along with the brief description of processes carried out at all such
locations/sites for which certification is sought (use separate blank sheet, if required)

3. Educational organization work on early childhood education (ECE): Yes No

4. Has organization is involved with providing special needs education to Special Challenged Students
…………………………………………………………………………………………..
ABMS 1. In Last 12 Months:
a. “Any Bribery Incidents” ……………………………………………..
b. “Legal Issues regarding Bribery” ……………………………………..

2. Provide Legislation Applicable as per location: ……………………………………………..

FMMS Number of personnel in simple functions …………………………………………………………………….…
(Finance, Admin, Human Resources, Security, Transport, Field Staff-Sales, Messengers, Drivers, Canteen,
Gardening, etc.)
Business and organization Complexity (ISMS/ITSMS)

Ref: SIS – F - 002 Issue No. 05 Rev. No. 01 Revision Date: 10.07.2024

Unit No. 514, 5th Floor,Vipul Business Park, Sohna Road, Sector – 48, Gurgaon-122018, Haryana, India.
Types of 1. Organization work in non-critical business sector and non-regulated sector
Business
and 2. Organization has customer in critical business sector.
regulatory 3. Organization works in critical business sector.
Requireme
nt
1. Standard Process with standard and repetitive task i.e., lots of persons doing work under the
organization’s control carrying out the same tasks, few products or services
Process and
Task 2. Standard but not repetitive process with high number of products or services
3. Complex Process, high number of products and services, many business units included in scope of
certification
Level 1. ISMS is already well established and/or other management system is in place.
establishme
nt of the 2. Some elements of other Management system are implemented, others not
Manageme 3. No other Management system implemented at all, ISMS is new and not established.
nt System
IT Environment Complexity (ISMS/ITSMS)
1. Few or highly standardized IT platforms, servers, operating system, database, networks etc.
IT
Infrastructur 2. Several different IT platforms, servers, operating system, database, networks etc.
e 3. Many different IT platforms, servers, operating system, database, networks etc.
Complexity
Dependenc 1. Little or no dependency on outsourcing
y on
outsourcing 2. Some dependency on outsourcing or suppliers, related to some but not all-important business
and activities.
suppliers 3. High dependencies on outsourcing or supplier, large impact on important business activities.
including
cloud
services
1. Non or very limited in-house system/application development
Information
System 2. Some in house or outsourced system/application development for some important business
Developmen purpose.
t 3. Extension in house or outsourced system/application development for important business purpose.
Are there any ISMS/ITSMS records that cannot be made available for review by the audit team
because they contain confidential or sensitive information?
ISMS/
ITSMS Kindly provide list of such information along with the corresponding justification:
………………………………………………………………………………………………………..

Ref: SIS – F - 002 Issue No. 05 Rev. No. 01 Revision Date: 10.07.2024

Unit No. 514, 5th Floor,Vipul Business Park, Sohna Road, Sector – 48, Gurgaon-122018, Haryana, India.
PIMS 1. Please confirm whether your organisation is a personally identifiable information(PII) processor,
data controller or both:
PII Processor PII Controller Both
2. Are you currently or has your business ever been under investigation/fined by a data enforcement
agency?
if yes, please provide details below:

3. Please detail below the data protection/privacy legislation applicable to your organisation: (e.g.
GDPR)
if yes, please provide details below:

4. Are you currently certified with ISO/IEC 27001? Yes No

Additional General Requirements

Primary English Hindi Other language ………………………………………………………
Language
Cheque Demand Draft NEFT or RTGS Others …………………………………
Payment
Method
Currency ₹ $ Others ……………………………………………………………………….
Used
Method of Email Fax Post Skype Phone call Others
Corresponde
nce
Declaration
The above information is true to the best of my knowledge and belief, and I am authorized to provide such information on
behalf of the company. The organization hereby undertakes to comply with the Certification regulations of SIS Cert. available
on the website: [Link]
Notes:
The quotation will be based on the information provided in the quotation request form.
Please indicate your preferred target dates for the following activities:
a) Document Review – (Specify Month/Year) ………………………...
b) Preliminary Review (Specify Month/Year) ………………………
c) Formal On-Site Review – (Specify Month/Year) ……………………
The surveillance period will be decided based on the review of application form.
For Client Use
Name

Designation

Ref: SIS – F - 002 Issue No. 05 Rev. No. 01 Revision Date: 10.07.2024

Unit No. 514, 5th Floor,Vipul Business Park, Sohna Road, Sector – 48, Gurgaon-122018, Haryana, India.
Date
Application Review (For SIS Head Office Use Only)
Accreditation

Scope/Code Evaluation

Resource Allocation

Review Status

Quotation Generation

SIS Certifications Pvt. Ltd.

Philippine Office: - Unit 211 2nd Flr., S&L Building 1500 R. Salas Street Roxas Blvd.
Ermita Manila Philippines

Contact us:
+63- 0917 700 0516 / 8731 5138
Email – jasonsiscert@[Link]
[Link]@[Link]

Ref: SIS – F - 002 Issue No. 05 Rev. No. 01 Revision Date: 10.07.2024

Unit No. 514, 5th Floor,Vipul Business Park, Sohna Road, Sector – 48, Gurgaon-122018, Haryana, India.